Idiopathic Basal Ganglia Calcifications in a Patient with Pediatric Onset Multiple Sclerosis
Muneer Almutairi1*, Sami AlShammari1 and Fahad Albassam1
1 Pediatric Neurology Department, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia.
*Corresponding Author: Muneer Almutairi, Pediatric Neurology Department, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia.
DOI: https://doi.org/10.58624/SVOANE.2024.05.0142
Received: June 23, 2024 Published: July 10, 2024
Abstract
Idiopathic Basal ganglia calcification, also known as Fahr’s Disease, has been associated with multiple etiologies. There have been case reports of basal ganglia calcifications in a number of patients with multiple sclerosis [MS]. Earlier hypothesis suggested the co-occurrence to be more than coincidental and might indicate an underlying overlapping pathophysiology of mitochondrial dysfunction. However further studies had failed to show higher prevalence of deep grey matter calcifications in MS individuals compared to healthy controls. Multiple sclerosis is known commonly to have a higher rate of co-existing autoimmune conditions (i.e., celiac disease, sarcoidosis, and type 1 diabetes etc.). In this case report we present an 11-years-old boy, known type 1 diabetes mellitus, who presented with a clinically isolated event in the form of cervical transverse myelitis. Neuroimaging fulfilled the Mcdonald criteria for dissemination in time and space, and he was diagnosed as clinically defined multiple sclerosis. Coincidentally his Brain CT showed symmetric globus pallidus calcification. The precedence of basal ganglia calcification brings into question the effects of early subliminal neuroinflammation on mitochondrial dysfunction and calcium deposition, and why it affects certain individuals. Previous studies had observed no correlation between multiple sclerosis and basal ganglia calcification when compared to the general population. The spectrum of mitochondrial dysfunction is known to be heterogenous, and may co-exist in Fahr’s disease or in MS. Further longitudinal studies for this cohort may help identify if basal ganglia calcification may serve as an early prognostic marker for disease progression in the subsequent decades.
Keywords: Multiple Sclerosis, Fahr Disease, Intracranial Calcifications, Basal Ganglia, Neuroinflammation.
Citation: Almutairi M, AlShammari S, Albassam F. Idiopathic Basal Ganglia Calcifications in a Patient with Pediatric Onset Multiple Sclerosis. SVOA Neurology 2024, 5:4, 149-153. doi: 10.58624/SVOANE.2024.05.0142
